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Audiology Praxis Practice Exam
practice exam

Additional Audiology Flashcards




The caloric test is designed to stimulate which of the following structures?
A. The utricle
B. The saccule
C. The superior semicircular canal
D. The posterior semicircular canal
E. The lateral semicircular canal
Option (E) is correct. The caloric test introduces a temperature differential that is designed to cause the fluid in the semicircular canal closest to the stimulus to move. The lateral semicircular canal is closest to the tympanic membrane, where the stimulus is introduced.
An audiologist fit a young woman with binaural digital behind-the-ear hearing aids three weeks ago. The patient reports that the devices have provided suitable amplification in most environments, but she complains that low-level ambient noise has been distracting.
In an effort to reduce the adverse noise effect, what adjustment might the audiologist make to the hearing aids?
A. Increasing the threshold kneepoint
B. Decreasing the threshold kneepoint
C. Enabling wide dynamic range compression
D. Decreasing the gain in all frequency bands
E. Enabling expansion
Option (E) is correct. Expansion reduces the gain of low-level ambient sounds.
Individuals with normal hearing sensitivity in one ear and a severe hearing loss in the other ear experience which of the following?
A. An improvement in speech understanding when the noise is closer to the ear with hearing loss
B. Improved ability to localize when the noise source is closer to the ear with normal hearing
C. Better speech understanding and localization as the reverberation time increases
D. More difficulty understanding speech when the speaker moves closer to the ear with hearing loss
E. Improved localization when the noise is at 0° azimuth and the source is closer to the ear with hearing loss
Option (A) is correct. It is well-known that for individuals with unilateral hearing loss, speech intelligibility improves when the more favorably placed ear (i.e., the better ear) is further from the noise source. When this occurs then the SNR improves in the better ear.
A patient is seen for a vestibular evaluation with the primary complaint of persistent imbalance for the past six months. She states that she had one severe attack of true rotary vertigo six months ago, and since then fears another will occur. She has limited her activities, as quick head movements increase her symptoms. She reportedly takes meclizine daily.
Videonystagmography results indicate normal saccade, optokinetic, and smooth pursuit testing. A second-degree left-beating nystagmus is observed during gaze testing without fixation. Postactive head-shake nystagmus reveals a left-beating nystagmus. No positioning or positional nystagmus is observed. Bilateral bithermal caloric results indicate a 50 percent right weakness with no significant directional preponderance.
Based on the above information, the patient most likely has
A. Ménière’s disease
B. a central vestibular pathology
C. a statically uncompensated peripheral pathology affecting the right ear
D. a dynamically uncompensated peripheral pathology affecting the left ear
E. a dynamically uncompensated peripheral pathology affecting the right ear
Option (E) is correct. Videonystagmography results normally provide site-of-lesion specific information (i.e., caloric irrigations) to determine probable side of weakness. In this example, the patient had a 50 percent right peripheral vestibular weakness, suggesting a peripheral pathology affecting the right side. The postactive head-shake left-beating nystagmus suggests that the lesion is dynamically uncompensated.
Which of the following is a possible outcome of an audiologist using a physician’s NPI for billing rather than using his or her own NPI?
A.The reimbursement for services rendered will be enhanced.
B.The incorrect validation of the physician as the predominant provider of audiology services.
C.The expansion of the scope of practice for audiologists.
D.The audiologist will not be liable for malpractice
E.The audiologist will no longer be eligible to maintain his or her own NPI.
Option (B) is correct. It is detrimental to the profession of audiology to have audiology services billed under the NPI of a physician. Doing so can skew the Medicare claims data to incorrectly indicate that physicians are the predominant providers of audiology services and, as a result, limit the role of the profession of audiology in national and regional audiology coding and reimbursement processes.
Auditory brainstem response (ABR) testing indicates a prolonged wave I–V latency. These findings are consistent with which of the following?
A.Retrocochlear pathology, such as an acoustic neuroma
B.Conductive hearing loss due to middle ear effusion
C.Cochlear hearing loss due to ototoxicity
D.Middle-ear dysfunction due to otosclerosis
E.Auditory perceptual problems as a result of a stroke
Option (A) is correct. A prolonged interval between waves I and V indicates a pathology in the area affected by neural conduction in the VIIIth nerve and the brainstem.
Which of the following is the most appropriate action for an audiologist to take when counseling a patient with a hearing impairment?
A.Encouraging the patient to buy a hearing aid
B.Recommending that the patient buy an assistive device
C.Informing the patient of his or her rehabilitative options
D.Persuading the patient to accept limitations in communications
E.Advising the patient to minimize public activity
Option (C) is correct. Informing patients about rehabilitative options offers them opportunities to learn how to manage hearing loss and improve communication.
Which of the following is an accurate statement concerning measures of speechreading ability?
A. Speechreading test results are likely to have a high correlation with measures of visual intelligence.
B. Intertalker differences are eliminated as a test variable when speechreading test results are scored on the basis of viseme recognition.
C. The most realistic measures of speechreading ability are administered in a visual mode only.
D. The most realistic measures of speechreading ability are administered in a combined auditory-visual mode.
E. The most appropriate material to use in measuring speechreading ability is nonsense syllables.
Option (D) is correct. Speechreading in actual use depends on both auditory and visual input for most clients. The measure of speechreading ability that best reflects a client’s real ability is one that is administered in a combined auditory-visual mode.
One component of the adult aural rehabilitation process is listening training. In listening training, the patient is trained to
A.use clear speech and assertiveness training
B.hear the frequencies within the human vocal range better alert, attentive, and set to receive communication
D.visually perceive phonemic differences
E.hear better in the presence of noise
Option (C) is correct. Being alert, attentive, and set to receive communication are the important components to improve listening
During subjective verification of hearing-aid directionality, a patient indicates that when noise comes from behind, the noise seems especially loud. Which of the following is most likely the cause?
A.Both microphone openings are probably blocked.
B.The microphones are probably wired backward.
C.Low-frequency gain is too high.
D.The vent is too large.
E.The vent is too small.
Option (B) is correct. Directional microphones are designed to reduce sounds from behind the listener. If the listener perceives that sounds are loud from behind, likely the front microphone is functioning like the back microphone and undesirable sounds are not being cancelled from behind.
Hearing-conservation programs for children often include screening with pure tones and acoustic immittance measures, whereas such programs for adults will likely use only pure tones for screening. Which of the following justifies this difference?
A.There is a significantly higher incidence of middle-ear pathology among children than among adults.
B.There is a significantly lower incidence of middle-ear pathology among children than among adults.
C.Screenings for children often take place in challenging acoustic environments.
D.Hearing-conservation programs for children primarily focus on the impact that middle-ear pathology can have on educationally significant hearing loss.
E.Acoustic-immittance measures for adults are less sensitive in identifying middle-ear pathology in adults.
Option (A) is correct. Acoustic-immittance measures, although they do not test hearing sensitivity, detect the possible presence of middle-ear pathology. For appropriate hearing care, therefore, both acoustic-immittance and pure-tone measures are necessary for children. Because adults are less susceptible to pathologies detected by acoustic-immittance measures, such measures are not efficient for adult screening programs.
Which of the following is true of the occlusion effect observed during pure tone audiometry?
A.It results in artificially poorer thresholds at all frequencies.
B.It can affect the measurement of air-conduction thresholds at low frequencies.
C.It can affect the measurement of air-conduction thresholds at high frequencies.
D.It can affect the measurement of bone-conduction thresholds at low frequencies.
E.It can affect the measurement of bone-conduction thresholds at high frequencies.
Option (D) is correct.The occlusion effect is the sensation of increased loudness of low-frequency sounds transmitted through bone conduction when the outer ear is blocked. In cases of conductive hearing loss, the greater the degree of hearing loss, the louder these sounds are likely to be perceived, so measurement of the bone-conduction threshold at low frequencies is affected.
Diagnostic audiometers generally provide one-third-octave noise bands for use in masking pure tones. This bandwidth is used because bands of that width
A.are centered in the frequency range of normal speech
B.encompass the width of a critical band
C.produce more masking than pink noise does
D.produce more masking than half-octave bands do
E.are less than the width of a critical band
Option (B) is correct. Narrow bands of masking noise should be wider than a critical band so that they will provide good masking for the frequency being tested without requiring high overall intensity just to achieve effective masking levels on that one frequency.
It is important to consider the gestational age of an infant, rather than the chronological age, when interpreting which of the following?
A.ABR Wave V latencies
B.DPOAE responses
C.TORCH factors
D.Apgar scores
E.WIPI scores
Option (A) is correct. Prematurity affects the stage of myelinization of the auditory nervous system, which affects the latencies of auditory evoked potentials up to 18 months of age.
An audiometer attenuator is set to 0 dB HL. Which of the following is true about the sound pressure level output at the earphone?
A.It is constant across all frequencies.
B.It is lowest at midfrequencies.
C.It increases as a function of frequency.
D.It is highest at 4000 Hz.
E.It decreases 6 dB per octave.
Option (B) is correct. The sound pressure level necessary to achieve 0 dB hearing level is highest at low frequencies, lessens in the middle frequencies, and then increases at high frequencies.
A patient in the early stages of Ménière’s disease will have an increase in the amount of endolymph in the inner ear. At the same time, audiometric assessment is likely to show sensorineural hearing loss that primarily affects which of the following frequency ranges?
A.All frequencies equally
B.250–2000 Hz
C.2000–4000 Hz
D.4000–8000 Hz
E.8000–10000 Hz
Option (B) is correct. The increase in the amount of endolymph in the inner ear expands the apical end of the cochlea because of a decreasing stiffness gradient of the basilar membrane. Since it is the low frequencies that are sensed in this location, it is the low frequencies that are diminished when there is too much endolymph.
A person calls to order tickets for a concert and is told that at the rear of the orchestra section, which is 20 meters from the stage, the average intensity is 65 dB SPL. The person decides to purchase tickets for seats that are 10 meters from the stage, where the sound-pressure level will average which of the following?
A.59 dB SPL
B.62 dB SPL
C.65 dB SPL
D.68 dB SPL
E.71 dB SPL
Option (E) is correct. According to the inverse square law, the sound intensity decreases by 6 dB when the distance from a sound source doubles. Conversely, the sound intensity increases by 6 dB when the distance to the sound source is halved.
The American National Standards Institute (ANSI) standard for classroom acoustics (ANSI/ASA S12.60) pertains to noise levels in unoccupied classrooms and recommended reverberation times. The ANSI standards are intended for use in the design of new classrooms and in the renovation of existing classrooms.
The recommended noise levels and reverberation times are
A.10 dBA or less and 0.1 seconds or less
B.50 dBA or less and 1.0 seconds or less
C.35 dBA or less and 0.6 seconds or less
D.55 dBA or less and 0.6 seconds or less
E.45 dBA or less and 4.1 seconds or less
Option (C) is correct. The ANSI standards for classroom acoustics specifies that ambient noise levels in unoccupied classrooms should not exceed 35 dBA and that reverberation times not exceed 0.6 seconds.
The cochlear implant signal-processing strategy in which brief pulses are presented to each electrode in a nonoverlapping sequence is known as
A.feature extraction
B.continuous interleaved sampling
C.fine structure
D.current steering
E.a filter bank
Option (B) is correct. Continuous interleaved sampling (CIS) is a cochlear implant signal-processing strategy that minimizes channel interaction by presenting pulses in a nonoverlapping sequence.
Which of the following is the primary reason investigators have given for limiting a hearing aid’s OSPL90 to a lower level when it is worn by a child than when it is worn by an adult?
A.Loud amplified sounds may frighten a young child and result in rejection of the hearing aid.
B.The volume of the external auditory meatus in children is less than that represented by a 2 cc coupler, and consequently the SPL at the eardrum is greater.
C.Measuring the degree of hearing loss in preschoolers is often imprecise and may lead to improper fitting of an aid.
D.Parents and teachers of children with hearing impairments typically talk louder than do people who interact with adults with hearing impairments.
E.The primary speech signal will be masked because room noise and reverberation will be amplified.
Option (B) is correct. The sound-pressure level (SPL) at the eardrum is a function of the volume of the external auditorymeatus: the smaller the volume, the greater the sound pressure. An OSPL90 set to a level appropriate for adults may produce an undesirably high maximum SPL in a child.
Which of the following evaluation measures is most likely to provide valid and reliable information about a typically developing 9-month-old child’s hearing sensitivity at 500 to 4000 Hz?
A.Visual reinforcement audiometry (VRA)
B.Pure-tone play audiometry
C.Otoacoustic emissions
D.Auditory brainstem response (ABR) audiometry
E.Behavioral observation audiometry (BOA)
Option (A) is correct. At 9 months, a typically developing infant can provide reliable responses to all octave band frequencies, and VRA is the most valid and reliable method for doing that: the infant’s behavior can be reinforced and will be consistent.
In the measurement of real-ear sound pressure levels with a probe microphone system, insufficient probe-tube depth will tend to
A. increase the high-frequency response
B. decrease the high-frequency response
C. decrease the response at all frequencies
D. decrease the low-frequency response
E. increase the low-frequency response
Option (B) is correct. Probe tubes for measuring real-ear sound pressure levels (SPL) should be inserted as close to the tympanic membrane as possible, because it is the SPL at the tympanic membrane that is being measured. If the probe tube is too far from the tympanic membrane, high-frequency sound waves bounced off the eardrum will dissipate before reaching the probe, but low-frequency sound waves, which do not dissipate as easily, will be essentially unaffected. The overall effect will thus be a decrease only in the high-frequency response.
Mr. Jones is a 92-year-old man with moderate sensorineural hearing loss, dementia, reduced manual dexterity, and a history of losing personal medical devices. He has limited financial resources but would like an amplification device for everyday use.
Which amplification device is the most appropriate recommendation for Mr. Jones?
A.FM system with receiver and transmitter
B.Personal listening system with headphones
C.Half-shell hearing aids
D.Receiver-in-the-canal hearing aids
E.Full-shell hearing aids
Option (B) is correct. Mr. Jones could benefit from amplification and given the factors of dementia and reduced manual dexterity, the best option is a personal listening system that is easy to use and less likely to get lost.
Which of the following is the optimal range of stimulation rates for determining threshold for a click ABR?
A.0.37 to 0.99
B.11.1 to 21.1
C.59.1 to 63.1
D.69.1 to 73.1
E.79.1 to 93.1
Option (B) is correct. A click rate range of 11.1 to 21.1 elicits an optimal auditory brainstem response.
The hearing-aid input transducer that is sensitive to electromagnetic energy is the
A.omnidirectional microphone
B.directional microphone
D.internal receiver
E.external receiver
Option (C) is correct. The telecoil is the only hearing-aid input transducer that is sensitive to electromagnetic energy.
Elicitation of an acoustic reflex at a hearing level better than that obtained with voluntary behavioral responses suggests the presence of
A.loudness recruitment
B.abnormal adaptation or tone decay
C.high impedance or low compliance
D.functional or nonorganic hearing loss
E.conductive hearing loss
Option (D) is correct. Better hearing levels with acoustic reflexes than with voluntary responses are obtained only in cases of nonorganic hearing loss. If a person has a nonorganic hearing loss, then poor hearing levels on voluntary behavioral response tests will be due to voluntary action. Acoustic reflex elicitation, however, is involuntary.
In order to minimize the chances of exacerbating tinnitus, which of the following should be avoided?
A.Exposure to high levels of chlorine
B.Using hearing protection devices
C.Taking high doses of beta carotene
D.High stress
E.High-intensity exercise
Option (D) is correct. High levels of stress can exacerbate tinnitus
Some individuals no longer go to the movies because their hearing loss makes it difficult for them to enjoy the experience. Which of the following domains of auditory function is being described by this behavior as defined by the International Classification of Functioning, Disability and Health from the World Health Organization?
A.Hearing impairment
B.Hearing handicap
C.Body function
D.Activity limitation
E.Participation restriction
Option (E) is correct. The individuals’ hearing impairment limits their ability to participate in an activity as a result of their having trouble understanding speech. Consequently, the individuals restrict their participation in activities that require them to understand speech, such as movies.
An audiologist is using a tracking procedure to assess a cochlear-implant patient’s progress in communicating under audition-plus-vision conditions. The materials used are articles from popular magazines. Data are collected for 15 minutes every working day for a week. Word-per-minute scores of 23.4, 43.6, 13.6, 54.2, and 27.3 are obtained. Which of the following is the most likely explanation for the variation in performance?
A.A learning effect
B.Variation in the print size used by the publishers
C.Variation in the vocabulary or syntax used by the authors
D.Normal response variation
E.Malfunction of the cochlear implant
Option (C) is correct. Tracking involves having the client repeat phrases read by the audiologist from different sources. Because each author has a different style, there will be considerable variation in how familiar the vocabulary is to the patient and in the number and degree of redundancy of syntactic clues, all factors that affect word-per-minute scores.
According to the contralateral masked-threshold function shown in the figure above, which of the following values represents the true threshold for the test ear?
A.50 dB HL
B.55 dB HL
C.65 dB HL
D.75 dB HL
E.95 dB HL
Option (D) is correct. According to the plateau method of determining true threshold, the true threshold is reached when the threshold of a test ear remains stable over a range of at least 20 dB increase in masking intensity. In the figure, the test-ear threshold plateaus at 75 dB.
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